Psoas Syndrome - Hitler Flashcards
Iliacus origin?
Insertion?
Superior 2/3 iliac crest, ASIS
Lesser trochanter
What drugs can treat psoas?
NSAID (MICN) Muscle relaxant (MCBC)
What do you not want to use when treating psoas syndrome?
Direct stretching or direct ME in acute setting
Heat
What are the major PE findings in psoas syndrome?
Tight iliopsoas
Loss of cervical/lumbar lordosis
Abdomen protuberant
Tight hamstrings
Where is the dysfunction in the piriformis stage of dysfunction?
Exam? Ex. Right side psoas
Opposite side from psoas
Left foot ER
Main fx of psoas?
Hip flexion
ER
How shouldn’t you sleep with psoas?
Avoid what else?
On stomach
Bend forward, lean backward when standing
What are the 5 stage progression steps of psoas syndrome?
BUSPS
B/l spasm U/l spasm Sacral torsion Piriformis spasm Sciatic n. irritation
What dysfunction for sciatica stage of psoas syndrome?
Exam?
Tx?
Left n. Irritation
Left leg paresthesia, NO neural deficit, + straight leg raise
Add low dose steroid
Exam findings w/right psoas on sacral stage?
R sacral sulci deep
L ILA post
+ spring test
How often should you passive stretch w/rolled towel?
Active stretch
Supine leg lifts?
TID
5-20x per day
6 inches
What treatment should you do in the u/l phase?
1st L1
2nd L2-L5
Psoas stretch
Muscle relaxant + NSAID
Psoas minor origin?
Insertion?
T12-L1 Vertebral bodies
Iliac fascia
What are common etiologies of psoas syndrome?
Laundry
prolonged sitting/bending Sit ups Deadlifts/squats Quick elongation of psoas Arthritis of hip V-S reflexes
What is the dysfunction for sacral torsion found in a tight left psoas?
R on L torsion - Axis on side of dysfunction
Right pelvic side shift - away from side of dysfunction
Give the order of OMT for treating psoas
L1 and L2 first Psoas Piriformis Sacrum Inominate Hip
You down with LPP?
SIH wit it
What exams you see in the u/l phase for Right psoas?
R psoas spasm
R short leg
R hip ER
Origin of psoas major?
Insertion?
Vertebral bodies of T12-L4 and TPs of L1-L5
Lesser trochanter
Pt w/difficulty lying prone, sitting or standing upright, and pain most likely has what?
Psoas syndrome
What is the dysfunction in the b/l spasm stage?
Tx?
Lumbar spine flexed
Counterstrain, passive stretch, indirect ME, NSAIDS
What orthopedic test is best used for psoas syndrome?
Thomas test
Tender points for psoas syndrome?
Iliacus
Low ilium
AL 1-5
What is the key dysfunction for a tight psoas found on the left?
L1 F RlSl
Piriformis origin?
Insertion?
Sacrum
Greater trochanter
